Mapping of apparent susceptibility yields promising diagnostic separation of progressive supranuclear palsy from other causes of parkinsonism

• Published in: Scientific reports 2019-04, Vol.9 (1), p.6079-6079, Article 6079
• Main Authors: Sjöström, Henrik, Surova, Yulia, Nilsson, Markus, Granberg, Tobias, Westman, Eric, van Westen, Danielle, Svenningsson, Per, Hansson, Oskar
• Format: Article
• Language: English
• Subjects: 59/57; 692/53/2421; 692/617/375/1718; 692/617/375/365; Aged; Atrophy; Basal ganglia; Basic Medicine; Brain diseases; Brain Mapping - methods; Central nervous system diseases; Clinical trials; Dentate nucleus; Diagnosis, Differential; Differential diagnosis; Diffusion Magnetic Resonance Imaging; Discriminant analysis; Female; Globus pallidus; Globus Pallidus - diagnostic imaging; Globus Pallidus - pathology; Humanities and Social Sciences; Humans; Iron - metabolism; Male; Mapping; Medical and Health Sciences; Medicin och hälsovetenskap; Medicinska och farmaceutiska grundvetenskaper; Middle Aged; Movement disorders; multidisciplinary; Multiple System Atrophy - diagnosis; Multiple System Atrophy - pathology; Neurodegenerative diseases; Neurosciences; Neurovetenskaper; Nuclei; Paralysis; Parkinson Disease - diagnosis; Parkinson Disease - pathology; Parkinson's disease; Progressive supranuclear palsy; Prospective Studies; Putamen; Putamen - diagnostic imaging; Putamen - pathology; Red nucleus; Science; Science (multidisciplinary); Substantia nigra; Substantia Nigra - diagnostic imaging; Substantia Nigra - pathology; Supranuclear Palsy, Progressive - diagnosis; Supranuclear Palsy, Progressive - pathology
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-019-42565-4

There is a need for methods that distinguish Parkinson’s disease (PD) from progressive supranuclear palsy (PSP) and multiple system atrophy (MSA), which have similar characteristics in the early stages of the disease. In this prospective study, we evaluate mapping of apparent susceptibility based on susceptibility weighted imaging (SWI) for differential diagnosis. We included 134 patients with PD, 11 with PSP, 10 with MSA and 44 healthy controls. SWI data were processed into maps of apparent susceptibility. In PSP, apparent susceptibility was increased in the red nucleus compared to all other groups, and in globus pallidus, putamen, substantia nigra and the dentate nucleus compared to PD and controls. In MSA, putaminal susceptibility was increased compared to PD and controls. Including all studied regions and using discriminant analysis between PSP and PD, 100% sensitivity and 97% specificity was achieved, and 91% sensitivity and 90% specificity in separating PSP from MSA. Correlations between putaminal susceptibility and disease severity in PD could warrant further research into using susceptibility mapping for monitoring disease progression and in clinical trials. Our study indicates that susceptibility in deep nuclei could play a role in the diagnosis of atypical parkinsonism, especially in PSP.